Organization
BAYSTATE ORTHOPEDICS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN H BULLOCK M.D. (PRESIDENT)
(413) 746-9142
Entity
Organization
Contact information
Practice address
3455 MAIN ST STE 2, SPRINGFIELD, MA 01107-1147
(413) 746-9142
Mailing address
3455 MAIN ST STE 2, SPRINGFIELD, MA 01107-1147
(413) 746-9142
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000006256
BMC HEALTHNET
MA
01
—
2002985
BLUE SHIELD
MA
01
—
455321
CONNECTICARE
MA
Enumeration date
05/04/2007
Last updated
08/22/2020
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